Advance Care Planning Bundle: Using Technical and Adaptive Solutions to Promote Goal Concordant Care

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2025-01-01 DOI:10.1016/j.jpainsymman.2024.09.014

Sara Brigham DO , Lori Olson MD, FACP , Jessica Kalender-Rich MD , Ben Skoch DO, MBA , Joanna Veazey Brooks MBE, PhD , Casey Pickering MS, MHSA, RN, CCRN , Dustin Pierce RN, CPHQ , Angella Herrman BSN, RN, NI-BC , Maritza Campos MSN, RN, NI-BC , Randa Hallock RN, MSN , Karin Porter-Williamson MD, FAAHPM

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引用次数: 0

Abstract

Background

Advance Care Planning (ACP) is critical to achieve goal-aligned care for patients. However, optimal implementation requires complex coordination and alignment across a healthcare system.

Measures

A survey of rapid response providers assessed usefulness of the ACP quality improvement bundle and perceptions of use and adherence.

Intervention

We implemented a bundle of advance care planning tools and interventions using the technical-adaptive framework. These included orders, documentation templates and processes, and standard education.

Outcomes

Ninety-three rapid response providers completed the survey. 80.5% reported that overall, these quality improvement efforts have been very helpful or somewhat helpful in improving their ability to provide care consistent with the patient's goals.

Conclusions/Lessons Learned

Implementation of technical and adaptive tools as a bundle for Advance Care Planning shows promise to improve and sustain goal-aligned care. Quality Improvement in ACP is a complex, iterative process involving both structural change and behavioral adaptation.

查看原文本刊更多论文

预先护理规划捆绑包：使用技术和适应性解决方案促进目标一致的护理。

背景：预先护理计划（ACP）对于实现患者护理目标的一致性至关重要。然而，要实现最佳实施效果，需要在整个医疗保健系统内进行复杂的协调和调整：对快速反应医疗服务提供者进行的一项调查评估了 ACP 质量改进捆绑包的实用性以及对使用和坚持的看法：我们利用技术适应框架实施了一套预先护理规划工具和干预措施。干预措施：我们采用技术适应性框架实施了一套预先护理计划工具和干预措施，其中包括医嘱、文档模板和流程以及标准教育：93 名快速反应医疗服务提供者完成了调查。80.5%的医疗服务提供者表示，总体而言，这些质量改进工作对提高他们按照患者目标提供护理的能力非常有帮助或有一定帮助：将技术和适应性工具作为预先护理规划的捆绑工具，有望改善和维持目标一致的护理。ACP 的质量改进是一个复杂、反复的过程，涉及结构变化和行为调整。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.